Gut Liver.  2017 Jan;11(1):73-78. 10.5009/gnl16194.

Underestimation of Smoking Rates in an East Asian Population with Crohn's Disease

• Hwang SW
• Seo H
• Kim GU
• Song EM
• Seo M
• Park SH
• Kwon E
• Lee HS
• Yang DH
• Kim KJ
• Ye BD
• Byeon JS
• Myung SJ
• Kim JH
• Yang SK

• KMID: 2412157
• DOI: http://doi.org/10.5009/gnl16194

Abstract

BACKGROUND/AIMS
The reported rates of current smoking at the time of Crohn's disease (CD) diagnosis tend to be low in East Asian studies. However, we hypothesized that East Asian patients may be reluctant to disclose their smoking history, likely because of the influence of the Confucian culture.
METHODS
We prospectively re-evaluated the smoking status at diagnosis in 1,437 Korean CD patients whose smoking status had been reported in our previous study.
RESULTS
After re-evaluation, the current smokers at diagnosis increased from 388 patients (27.0%) to 445 patients (31.0%), indicating that 12.8% (57 of 445 patients) of the current smokers at diagnosis did not disclose their smoking status at their initial evaluation. The proportion of current smokers at diagnosis who had initially concealed their smoking status was significantly higher among the female patients (29.7%, 11/37) compared with the male patients (11.3%, 46/408) (p<0.005) and among the patients who were ≤18 years old at diagnosis (56.4%, 22/39) compared with the patients >18 years old at diagnosis (8.6%, 35/406) (p<0.001).
CONCLUSIONS
Subgroups of Korean CD patients, particularly young patients and female patients, are reluctant to disclose their smoking history. Therefore, the suggestion that smoking is not a risk factor for the development of CD in East Asians should be made with caution.

Keyword

Crohn disease; Smoking; Age at diagnosis; Sex

MeSH Terms

Adolescent
Adult
Aged
Child
Crohn Disease/*epidemiology
*Disclosure
Far East/epidemiology
Female
Humans
Male
Middle Aged
Prevalence
Prospective Studies
Republic of Korea/epidemiology
Risk Factors
*Self Report
Sex Factors
Smoking/*epidemiology
Young Adult